RSS Feedhttps://10.40.239.129/blogs/rss-feed/Blog RSS Feeden{8165A6E3-BC7A-40A4-AE60-203BEB04D392}https://10.40.239.129/blogs/2017/05/how-genetic-testing-can-determine-your-cancer-risk/How Genetic Testing Can Determine Your Cancer RiskGenetic testing is quickly evolving as more genes are discovered and the cost of the testing becomes cheaper. How do you know if it&rsquo;s right for you?&nbsp;
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<div>Just like eye and hair color, genes are passed along from our parents. Sometimes those genes can develop mutations, and if you inherit a gene linked to cancer you&rsquo;re more likely to develop the disease &mdash; and at a younger age.&nbsp;</div>
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<div>"A genetic test can tell you if you carry a predisposition for certain cancers, such as such as hereditary breast and ovarian cancer,&rdquo; says Nykole Sutherland, a &lrm;Clinical Genetic Counselor at Intermountain. The test also helps suggest if other family members are at risk.&nbsp;</div>
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<div>If you have a family history of cancer you are a good candidate for genetic testing. Prior to the test, patients receive a referral to a genetic counselor by their physician. The counselor will provide a detailed risk assessment, which includes drawing a full family tree to determine if there are genetic signs of cancer. The genetic counselor helps patients know what to expect with the test, what the results mean, and the pros and cons of testing.&nbsp;</div>
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<h3>What happens after the test?</h3>
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A simple blood test is all that is required for a genetic test, but the results can have significant implications. "Unlike many blood tests, a genetic test can indicate that you might have relatives, such as your children or siblings, who are potentially at-risk," says Nykole.
For example, if the result is positive, meaning a genetic change was found that is known to increase risk for cancers, the genetic counselor will go over the medical recommendations for cancer prevention and who else in the family should consider being tested. Examples of medical management recommendations for a breast gene (such as BRCA1 or BRCA2) might be that all the women in the family have breast MRIs in addition to breast mammograms.&nbsp;</p>
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RELATED: <a href="https://intermountainhealthcare.org/blogs/2016/12/8-faqs-about-the-breast-cancer-gene/ ">8 FAQS about the Breast Cancer Gene </a></p>
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<div>&ldquo;Everyone has different risks, and the medical management is guided by what helps the patient feel empowered and safe,&rdquo; says Nykole. While genetic testing cannot predict for certain if cancer will develop, it does provide information that can be used toward prevention, diagnosis, and treatment.
Nykole adds that while not all patients want be tested, genetic counselling is still helpful for any family member at risk, as each patient is provided with specialized cancer screening recommendations based on their family history.&nbsp;</div>
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<h3>The future of testing</h3>
<p>&nbsp;"The role of genetics in cancer prevention, diagnosis, and treatment will continue to gain importance at Intermountain," says Nykole. "In the future I expect that precision genomics will be an integrated part of cancer care." For more information about Intermountain Cancer Services visit <a href="https://intermountainhealthcare.org/services/cancer-care/" target="_blank">here</a>.&nbsp;</p>
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RELATED: <a href="https://intermountainhealthcare.org/blogs/2015/08/precision-genomics-in-action-telitha-greiners-story/">Precision Genomics in Action: Telitha Greiner's Story</a></p>
</div>Wed, 10 May 2017 00:00:00 -0600{2680471A-C1BA-4692-A26A-F943A8DC2FA0}https://10.40.239.129/blogs/2017/05/does-an-abnormal-mammogram-mean-i-have-breast-cancer/Does an Abnormal Mammogram Mean I Have Breast Cancer?<p>If you&rsquo;re told your mammogram is abnormal, Rule #1 is: there&rsquo;s no need to panic. </p>
<p>According to the American Cancer Society, <a href="https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/mammograms/getting-called-back-after-a-mammogram.html" target="_self">less than 10 percent of women called back for more tests after a screening mammogram are found to have breast cancer</a>.&nbsp;</p>
<p>&ldquo;Of 1,000 women who get a screening mammogram, 100 will come back for additional imaging. Of those 100, only about five will end up being diagnosed with breast cancer,&rdquo; says Brett Parkinson, MD, radiologist and director of the breast care program at <a href="http://intermountainhealthcare.org/hospitals/imed/services/women/Pages/Mammography.aspx" target="_blank">Intermountain Medical Center</a> in Salt Lake City. </p>
<p><strong>RELATED:&nbsp;<a href="https://intermountainhealthcare.org/blogs/2017/03/the-mammogram-a-cant-miss-screening">The Mammogram: A Can't-Miss Screening</a></strong></p>
<p>&ldquo;It&rsquo;s important to complete further diagnostic testing to determine if the abnormality in the breast is non-cancerous or cancerous,&rdquo; says Dr. Parkinson. &ldquo;Doing additional breast imaging provides more detailed information about your case and helps you and your physician make decisions about further evaluation.&rdquo; </p>
<h2>What is an Abnormal Mammogram Result?</h2>
<p>There are a few reasons a mammogram may be considered abnormal: calcifications, masses or tissue distortion. All of these may be benign entities, however, a small percentage can be malignant.</p>
<ul>
<li><strong>Calcifications</strong> are calcium deposits in a suspicious cluster or pattern</li>
<li><strong>Masses</strong> can be lumps, cysts, or tumors</li>
<li><strong>Tissue distortion</strong> is when the architecture of the breast tissue is abnormal</li>
</ul>
<p>If your screening mammogram is abnormal, a radiologist will likely recommend further imaging such as: </p>
<ul>
<li>Diagnostic mammogram</li>
<li>Breast ultrasound </li>
<li>Breast MRI for high-risk patients<strong></strong></li>
</ul>
<p>&ldquo;Waiting for the results of a diagnostic mammogram and other tests can be frightening,&rdquo; says Nancy Smith, a mammography manager for Intermountain Healthcare. &ldquo;Many women have strong emotions when their screening mammogram comes back as abnormal, including disbelief, anxiety, fear, anger, and sadness. It&rsquo;s very common to have those feelings.&rdquo;</p>
<p><strong>You may also need a biopsy</strong>, which means getting a sample of tissue from the abnormal area and sending it to a pathologist for diagnosis. Approximately 15 percent of women who are called back for further imaging will undergo a biopsy, according to the American College of Radiology. </p>
<p>Types of breast biopsies include a needle core biopsy or surgical biopsy, depending on your case. &ldquo;In 95 percent of cases a needle biopsy is sufficient,&rdquo; says Dr. Parkinson. &ldquo;Of the women who undergo a needle biopsy, just 30 percent will have cancer.&rdquo;</p>
<ul>
<li><strong>A needle biopsy</strong> produces minimal scarring, allows diagnosis of breast cancer without taking a patient to the operating room, and allows all options of breast cancer treatment to still be considered, including clinical trials.</li>
<li><strong>A surgical biopsy</strong> may be recommended due to the location or type of the lesion, or if previous imaging or needle biopsy results are inconclusive.</li>
</ul>
<p>If it&rsquo;s cancer,&nbsp;you&rsquo;ll usually be referred to a general surgeon, who will discuss treatment options with you, which may include surgery to remove the tumor, radiation, chemotherapy, and/or hormone therapy. Depending on the individual case, one or more of these options is recommended. </p>
<p><strong>Complete breast cancer care is best provided by a team of specialists</strong></p>
<p>Typically, your general surgeon will talk over your case with a multi-disciplinary breast cancer tumor board to reach consensus on the order and type of treatment recommended. The board usually includes surgeons, pathologists, oncologists, radiation oncologists, breast care coordinators, genetic counselors, and lymphedema specialists who&rsquo;ve treated a wide range of breast cancer patients.</p>
<p>&ldquo;In my experience, most breast cancer patients get surgery first to remove the cancerous mass and check for spread to the lymph nodes, but each case is different,&rdquo; says general surgeon Alice Chung, MD, who does breast cancer surgery at Intermountain Riverton Hospital.</p>
<p>&ldquo;There are research-based guidelines for breast care, but each case presents subtle differences that should be discussed individually. Eligibility to participate in clinical research trials can also be addressed,&rdquo; she adds.</p>
<p>Typically, general surgeons perform breast surgery to remove cancerous tissue and plastic surgeons perform reconstructive breast surgery.</p>
<p>&ldquo;Many general surgeons do breast surgery to remove cancerous tissue and some specialize in it,&rdquo; says Teresa Reading, MD, a general surgeon who specializes in breast surgery at Intermountain Healthcare. &ldquo;Depending on the surgery recommended, reconstructive options can also be discussed with a plastic surgeon.&rdquo;</p>
<p>If you&rsquo;re considering breast cancer surgery, see the <a href="https://breast360.org/en/" target="_self">American Society of Breast Surgeons Foundation</a> website:&nbsp;</p>
<h2>Important breast cancer facts:</h2>
<ul>
<li>One in eight women will develop breast cancer over the course of her lifetime.</li>
<li>75 percent of breast cancers occur in women with no known risk factors.</li>
<li>Screening mammography is the best method of early breast cancer detection.</li>
<li>If women aren&rsquo;t screened early and regularly for breast cancer, the treatment becomes complicated and survival rates decrease. </li>
</ul>
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<h3>When should you get your first mammogram and how often do you need them?</h3>
<p>&ldquo;If you&rsquo;re a woman of average risk, you should begin annual screening mammography at age 40,&rdquo; says Dr. Parkinson. &ldquo;However, if you have a family history of breast cancer or have the breast cancer gene BRCA-1 or BRCA-2, you should begin screening earlier, and may be a candidate for MRI screening.&rdquo; Talk to your physician for recommendations if you have a mother, sister, or daughter who&rsquo;s had breast cancer. If you have one of the breast cancer genes, you may consider consulting with a genetics counselor at a breast care center.</p>
<p><strong>RELATED:&nbsp;<a href="https://intermountainhealthcare.org/blogs/2015/04/question-for-women-when-to-start-regular-mammograms">The Question for Women: When to Start Regular Mammograms?</a></strong></p>
<p><strong>3D digital mammography or tomosynthesis provides a more detailed picture</strong></p>
<p>Tomosynthesis provides a 3D image of the breast that can be viewed in thin slices to more accurately show breast abnormalities. Screening mammograms may or may not include tomosynthesis and some insurance plans may not cover it. If it&rsquo;s available and is covered by your insurance, you may want to request tomosynthesis, since it provides much more detailed pictures. &nbsp;All Intermountain breast care centers have tomosynthesis available. Tomosynthesis has been <a href="http://pubs.rsna.org/loi/radiology" target="_self">shown to slightly increase the cancer detection rate and decrease false positive results from screening</a>.</p>
<p><strong>RELATED: <a href="https://intermountainhealthcare.org/blogs/2016/11/3d-mammography-provides-best-breast-imaging">3D Mammography Provides the Best in Breast Imaging</a></strong></p>
<p>In addition to mammograms, the American Cancer Society recommends women should be familiar with how their breasts normally look and feel and <a href="https://www.cancer.org/latest-news/breast-cancer-symptoms-what-you-need-to-know.html" target="_self">report any changes</a> to their healthcare provider right away.</p>
<p>All Intermountain Healthcare Breast Care Centers meet national benchmark guidelines for breast cancer detection.</p>Wed, 10 May 2017 00:00:00 -0600{14BE4DF4-D525-41A4-9C5F-1B60AD4FC20B}https://10.40.239.129/blogs/2017/05/advanced-practice-clinicians-valuable-members-of-your-healthcare-team/Advanced Practice Clinicians: Valuable members of your healthcare team<p>We want to introduce you to a valuable member of your healthcare team, Physician Assistants (PA) and Nurse Practitioners (NP). PAs and NPs, also known as Advanced Practice Clinicians (APC) are becoming more and more common in the clinic setting, and their value to patient care is growing as healthcare continues to change and expand.</p>
<p>APCs work in all parts of healthcare, from primary care to specialties and surgery. In a primary care setting an APC might have their own group of patients that they care for, or they might assist with overflow to support a clinic&rsquo;s physicians. In specialty departments an APC will often support a physician by jointly seeing new patients when appropriate, seeing routine follow ups, rounding on hospital patients and assisting in surgery. </p>
<p>There are some important things APCs want you to know regarding how they fit into providing patient care (see side bar). One thing that should be understood is the value they bring patients, physicians and clinics.</p>
<h2>What APC&rsquo;s Want You to Know</h2>
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<li><strong>We are educated and qualified to care for your health.</strong> PAs and NPs receive three years of additional training after their undergraduate education. You could say we earn a Master&rsquo;s Degree in medical training. We are required to take a certification exam and maintain this certification with ongoing education. </li>
<li><strong>We can provide for your healthcare needs.</strong> In some cases PAs and NPs can exclusively provide for your healthcare needs. We can prescribe medication, order blood work and imaging studies, admit to a hospital and perform procedures in the clinic. </li>
<li><strong>We know our limits.</strong> As APCs we understand the level of care we are able to provide and work in sync with physicians when more advanced or surgical care is needed. We won&rsquo;t hesitate to seek additional support from physicians when the need arises. </li>
<li><strong>You can call us by our first name.</strong> Many patients want to be respectful, but don&rsquo;t know how to address us. We are not doctors, so calling us &ldquo;Doctor&rdquo; isn&rsquo;t appropriate. We are comfortable with being addressed by our first name, or &ldquo;Mr. or Ms.&rdquo; </li>
<li><strong>You can see the physician if you want.</strong> We hope to explain your condition and treatment and build a rapport so you feel comfortable with us providing your care. However, we understand if you have an expectation to see your physician when you visit our clinic. We won&rsquo;t be offended if you ask to see your doctor for his or her opinion or to answer questions. We try to provide every opportunity to see the physician if you request it.</li>
</ul>
<h3>Improved Access to Care</h3>
<p>As healthcare continues to evolve, there is a focused effort to provide quality medical care for the people in our communities. APCs, working with physicians as a team, help to create more access for patients to get the care they need when they need it. </p>
<p>Practices that employ APCs are able to run more efficiently and see more patients on a given day. APCs allow the physician to almost be in two places at once, providing more opportunity to care for patients in need. PAs and NPs have the knowledge and skills to treat many of the common conditions that come into the clinic, allowing the physician to spend more time on the complex cases that may require more expertise. </p>
<h3>Improved Patient Education</h3>
<p>APCs not only allow more patients to be seen in the clinic, they also make it possible to spend time educating patients during the appointment. With the extra time patients are able to ask questions and gain understanding of their diagnosis and treatment. APCs can address concerns and help patients feel comfortable about their treatment plan. </p>
<h3>Improved Quality </h3>
<p>Each member of your healthcare team plays an important role in creating your treatment plan. Working together, physicians and APCs are able to make better decisions for patient care. Experienced APCs are trusted by physicians to provide input regarding diagnosis, treatment and patient concerns. This team approach improves the quality of care you receive. </p>
<p>Nurse Practitioners and Physician Assistants are valuable members of your healthcare team. They are educated, experienced and skilled to manage patient care in a variety of settings. When you receive care from an APC, know that you are in qualified hands that care about your health and can help you achieve the healthiest life possible.</p>Tue, 09 May 2017 00:00:00 -0600{4DDBCD2D-0A2E-4AAE-977C-0C3896F7CFDC}https://10.40.239.129/blogs/2017/05/new-research-of-heart-rhythm-disorders-seeks-to-slow-the-prevalence-of-this-growing-disease/New Research of Heart Rhythm Disorders Seeks to Slow the Prevalence of this Growing Disease<p>The growing prevalence of heart rhythm disorders in the United States is a significant health problem &mdash; including atrial fibrillation, [<a href="https://www.google.com/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=1&amp;ved=0ahUKEwjegpq12tnTAhUV6GMKHZN2Cj0QFghGMAA&amp;url=http%3A%2F%2Fwww.hrsonline.org%2Fcontent%2Fdownload%2F8344%2F363468%2Ffile%2FAF%2520Fact%2520Sheet%252010.2012.pdf&amp;usg=AFQjCNGYKK4dPgNQ3V9I3-gYLxuiYPLqBQ" target="_blank">HRS FACT SHEET</a>] which affects more than three million Americans. It&rsquo;s the most common sustained heart rhythm disorder in the nation, and increases the risk for heart disease and stroke, both of which are leading causes of death here and throughout the world.</p>
<p>In our clinic alone &mdash; the<a href="https://intermountainhealthcare.org/services/heart-care/heart-institute/" target="_blank"> Intermountain Medical Center Heart Institute</a> in Salt Lake City &mdash; we&rsquo;ve seen our outpatient clinic volumes rise by five percent each year since 2013. Abnormal heart rhythms can be a serious issue, which many experts from around the world are working to address.</p>
<p>The term "arrhythmia" refers to any change from the normal sequence of electrical impulses. The electrical impulses may happen too fast, too slowly, or erratically &ndash; causing the heart to beat too fast, too slowly, or erratically. When the heart doesn't beat properly, it can't pump blood effectively.</p>
<p>When this happens, the lungs, kidneys, and brain and many other organs may not work properly and may over time become damaged. At times organ damage can become a life-threatening situation. In addition, abnormal rhythms from the lower heart chambers, such as ventricular tachycardia and ventricular fibrillation, a condition in which the lower heart chambers only quiver and do not effectively pump blood, can result in cardiac arrest and sudden death.</p>
<p>In order for the field of medicine to advance, caregivers and patients need to stop accepting the status quo. Questions should be asked and research executed in order to identify best practices in both the prevention and treatment of heart rhythm disorders.</p>
<p>This May, more than 12,000 physicians, researchers, and caregivers from 90 different countries will meet in Chicago for Heart Rhythm 2017, the <a href="http://www.hrssessions.org" target="_blank">Heart Rhythm Society&rsquo;s 38th annual Scientific Sessions</a>, to discuss the latest science, cutting-edge technologies, and best evidence-based practices that improve the prevention and treatment of heart rhythm disorders.</p>
<p>The Intermountain Medical Center Heart Institute&rsquo;s team of heart rhythm experts are presenting or involved in 16 different research studies that will be shared during the four-day conference. This includes several homegrown studies, in addition collaborative studies with organizations like UCLA, Harvard, University of Pennsylvania, University of Kansas and University of Colorado, and the Texas Heart Institute.</p>
<p>Some of the research topics we&rsquo;re presenting at the conference include:</p>
<p>
</p>
<ul>
<li>How to minimize the risk of dementia in patients with atrial fibrillation</li>
<li>Ways to improve risk stratification of patients with stroke, bleeding, or dementia</li>
<li>The use of aspirin in reducing the risk of stroke and bleeding in low-risk atrial fibrillation patients</li>
<li>The creation of large animal models of atrial fibrillation that will help us better understand the disease and improve treatment options.</li>
<li>Circulating microRNAs that are promising biomarkers that can be collected from routine blood draws that help predict people at risk of atrial fibrillation incidence, severity, and response to therapies</li>
<li>Cost effectiveness studies of catheter ablation for atrial fibrillation compared to medical therapies and between different stroke prevention strategies.</li>
<li>How to select and treat people with severe heart disease and ventricular tachycardia that present with implantable cardioverter-defibrillator shocks</li>
</ul>
<p>In addition to presenting new research from our organization, I&rsquo;m particularly looking forward to a presentation of a promising new medication that can be delivered through a nasal spray and can rapidly stop certain abnormal rapid heart rhythms, and new research on the long-term durability of subcutaneous ICDs and <a href="https://intermountainhealthcare.org/blogs/2014/08/utah-first-implant-of-non-surgical-leadless-cardiac-pacemaker/" target="_blank">implantable leadless pacemakers</a>.</p>
<p>We&rsquo;re in a unique time of growth when it comes to heart rhythm research. New technologies allow us to not only look at things we weren&rsquo;t previously able to explore, but to collaborate in ways we never thought possible. There&rsquo;s strength in numbers, so the opportunities our organization has had to collaborate with other organizations allow us to present new research that can change the way we look at preventing and treating this disease.</p>
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</p>Mon, 08 May 2017 00:00:00 -0600{B68F108E-AB15-4919-9A01-F258C204F2F7}https://10.40.239.129/blogs/2017/05/the-physical-side-of-anxiety/The Physical Side of Anxiety<p>The brain is a powerful organ. So much that the anxiety, the depression, and the fear can turn mental fears into actual physical pains. </p>
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<p>&ldquo;Most people actually experience anxiety as a physical problem,&rdquo; said Jason Conover, social worker for Intermountain Healthcare&rsquo;s Utah Valley Hospital. &ldquo;It often doesn&rsquo;t get recognized because the physical symptoms are so apparent and quite troubling that they might think they are experiencing something else &ndash; for instance, a heart attack.&rdquo; </p>
<p> </p>
<p>Anxiety builds tension throughout the body. Conover said in the brain can react to thoughts of fear and turn to the muscles to brace for a moment that is not happening. Much like if you were about to get in an accident or protecting your body to get punched. The action never happens but chemically you just experienced it just from a random fear thought that crept in.</p>
<p> </p>
<p>Treating anxiety is important for better mental health and physical health as well. Inflammation builds up from the stress, and inflammation is a culprit in numerous chronic conditions &ndash; such as heart and gastrointestinal conditions.</p>
<p> </p>
<p>Here are several ways that anxiety manifests in physical problems.</p>
<p> </p>
<p><strong>Breathing</strong> &ndash; Due to the tension, your breathing can change, Conover said. Breathing can become shorter, shallower, or even holding your breath too long. The lungs do not fully exhale due to the tension. Relaxation and breathing techniques can help.</p>
<p> </p>
<p>&ldquo;So if we practice letting go of all that air until our lungs are empty &ndash; then we can slow our breathing,&rdquo; Conover said.</p>
<p> </p>
<p><strong>Tight Muscles</strong> &ndash; Anxiety will run tension through the body and impact different muscles. People feel the tightness in other areas. Some will feel it in their neck, jaw, chest, or the stomach. There is no specific area &ndash; wherever the brain sends the nerve signals. </p>
<p> </p>
<p>If muscle tightness continues in an area for a long time, then it turns the muscle tightness into actual pain. </p>
<p> </p>
<p><strong>Rapid Heart Beat</strong> &ndash; Heart rate&rsquo;s changes can occur from different sources. The shortness of breath will cause the heart to pump more oxygen into the blood to compensate. </p>
<p> </p>
<p>Another way the heart rate is affected is anxiety will drive adrenaline. Typically released in moments of intense actions like sky diving or mountain climbing. But these moments can happen from impending thoughts in anxiety that are mediocre. Such as a fear of meeting someone or standing up in front of a group.&nbsp; The adrenaline cue leaves people feeling shaky or a general off-feeling.</p>
<p> </p>
<p><strong>RELATED</strong>: <a href="https://intermountainhealthcare.org/blogs/2015/02/stress-and-heart-disease/" target="_blank">Stress and Heart Disease</a></p>
<p> </p>
<p><strong>Sweating, Cold Extremities, and Light-Headed</strong> &ndash; Blood flow contributes to these symptoms. In moments of panic, the body goes into emergency mode. </p>
<p> </p>
<p>&ldquo;The body in emergencies will pull blood to main organs &ndash; the heart and the large muscles,&rdquo; Conover said. </p>
<p> </p>
<p>Sweating will be common for anxiety where extra perspiration happens during those moments. Cold hands, feet, fingers and toes happen because blood is being pulled away to protect those major organs. &nbsp;Also, people with anxiety will feel periods of dizziness, light-headed.</p>
<p> </p>
<p><strong>Stomach Issues</strong> &ndash; &ldquo;One of the all-time classic symptoms is the stomach,&rdquo; Conover said. As there are numerous gastrointestinal problems that can come with anxiety. Diarrhea, constipation and acid reflex are a few examples. </p>
<p> </p>
<p>Tension in the muscles causes complications as well as the blood flow wreaking havoc. Digestion suffers as the stomach does not fully empty.</p>
<p> </p>
<p><strong>Seek Help</strong> </p>
<p> </p>
<p>Anxiety should be treated the same as any chronic health illnesses. Speak to your family doctor about your emotions and feelings. Providers can give assistance and treatment plans for you to help manage anxiety and the physical manifestations that come along with it.&nbsp; </p>
<p> </p>
<p>There are also relaxation activities that can help give relief: meditation, yoga, and visualization techniques. Just as the body experiences chemical reactions to negative thoughts, the brain also has the same biological change on happy thoughts. Picture yourself in your favorite place of the world or in your happiest moment. </p>
<p> </p>
<p>Visit <a href="https://intermountainhealthcare.org/services/behavioral-health/conditions/anxiety-disorder/" target="_blank">Intermountain&rsquo;s website</a> for more information on anxiety disorders, symptoms and care.</p>
<p><br />
</p>Fri, 05 May 2017 00:00:00 -0600{68A05B13-9931-40F1-98BA-0670522E49FF}https://10.40.239.129/blogs/2017/05/what-you-need-to-know-about-your-visit-to-the-er/What You Need to Know About Your Visit to the ER<p>Most patients who come to the Emergency Room, also known as the Emergency Department, will be asked to wait after reviewing their condition with a triage nurse. Patients need to remember what they do in the waiting room may impact the rest of their visit:</p>
<ul>
<li><strong>Eating/Drinking:</strong> In the Emergency Department, we may need to do tests/procedures to rule out various illnesses. Some of these tests require patients to have an empty stomach. If you&rsquo;d like to eat/drink something while you wait, please talk with an Emergency Department staff member prior to doing so.</li>
<li><strong>Restroom:</strong> If you need to use the restroom while in the waiting room, please notify a staff member. The staff may want to collect a sample.</li>
<li><strong>Medications:</strong> Medications can have many adverse side effects and require that patients be watched closely on a monitor. We refrain from giving pain medication in the waiting room for your safety. After a provider evaluates you, he or she will be able to give you appropriate medication and you will be closely monitored for side effects.</li>
<li><strong>Pain control:</strong> We strive to keep each patient comfortable. Items we can provide at any time during your Emergency Department visit to help address your pain include: heat packs, pillows, ice packs, blankets, ear plugs and eye masks. We can&rsquo;t guarantee you&rsquo;ll be pain free during your stay, but we&rsquo;ll do all that we can to help make you feel more comfortable.</li>
<li><strong>Mask:</strong> If you have a cough, fever, or any flu-like symptoms, we ask that you wear a mask. By wearing a mask, you protect others from being exposed to illness.</li>
</ul>
<h2>An Emergency Department Visit Takes Time</h2>
<p>An average Emergency Department stay is 3 to 5 hours. A visit may be more or less depending on the tests and plan of care the physician chooses for each patient. Circumstances such as critical patients who come to the Emergency Department unexpectedly or a large volume of patients can increase the length of your visit.</p>
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RELATED: <a href="https://intermountainhealthcare.org/blogs/2014/04/instacare-vs-er/">InstaCare vs ER</a></p>
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<h3>The Quantity and Type of Tests Influence the Length of Your Visit</h3>
<p>Radiology, labs, or any other tests done in the Emergency Department take an hour or more to complete. All tests must be completed before the physician can interpret and determine an appropriate plan of care. Every test a physician adds to the initial plan of care increases the length of your visit. If admitted, it can take 1 to 2 hours to consult with the admitting physician, have the admitting physician evaluate your condition, and receive a bed on the appropriate floor of the hospital.</p>
<h3>Why Some Patients Are Seen Before Others in the Emergency Department</h3>
<p>Some patients may be seen before you, even if they arrived after you did. After the triage nurse assesses each person, he or she makes a determination regarding the severity of each patient. Patients in the Emergency Department are seen by the severity of their symptoms and vital signs and not by wait time. We understand this process can increase or change your wait time and we appreciate your patience. If your condition worsens, please notify the nursing staff.</p>
<h2>Emergency Department Caregivers Want to Help</h2>
<p>During your stay, you&rsquo;ll see many staff members. Each caregiver wears something different:</p>
<ul>
<li>Physicians, physician assistants, and nurse practitioners: Green scrubs or professional clothing</li>
<li>Nurses: Navy blue scrubs</li>
<li>Emergency Department techs: Light grey scrubs</li>
</ul>
<p>All of our doctors are board-certified emergency medicine physicians. They can run a variety of tests and procedures in an effort to determine what is causing your symptoms. Occasionally, they&rsquo;re unable to figure out an exact cause.</p>
<p>In these instances, you&rsquo;ll be asked to follow up with a physician after leaving the Emergency Department to continue the process of diagnosis and treatment. It&rsquo;s extremely important that you follow Emergency Department discharge instructions.</p>Thu, 04 May 2017 00:00:00 -0600{8AE860E2-2674-4124-BF1E-EBC54A93238F}https://10.40.239.129/blogs/2017/05/5-tips-for-aya-cancer-caregivers/5 Tips for AYA Cancer Caregivers<p>In the summer of 2014, after a glorious week spent boating, hiking and exploring the sunset orange cliffs and emerald waters of Lake Powell, I returned home completely unaware of just how much my life was going to change in the matter of a few weeks. </p>
<p>A month after our Lake Powell adventure, Bryan, my best friend of 17 years, told me he had cancer. Not only that, it was Stage 4 Melanoma. A mere week after this crushing news, Bryan was rushed into emergency surgery to remove the golf ball sized lesion that was pressing against his spine, threatening to paralyze him.</p>
<p>I can say without a doubt that being an <a href="https://intermountainhealthcare.org/services/cancer-care/huntsman-intermountain/hi-aya/" target="_blank">adolescent and young adult (AYA) cancer caregiver </a>is one of the hardest things you will ever do. It is physically, emotionally and mentally exhausting; but none of that compares to what your loved one is undergoing with their cancer treatment. Seeing them endure unspeakable procedures, endless tests and suffer unyielding pain is almost physically painful for us as caregivers. It is the worst feeling in the world to see someone you love face such a horrific disease. </p>
<br />
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<p>RELATED: <a href="http://huntsmancancer.org/circle-of-hope/2017/the-club-you-never-asked-to-join.php">The Club You Never Asked to Join - Huntsman Cancer Institute</a></p>
</div>
<br />
<p>In helping my best friend, I learned more about cancer than I ever wanted to; but I also learned about humility, the beauty of human resilience, the difference a random act of kindness can make, and most importantly, I learned what it means to truly live every single day. Here are five tips to help you navigate being a caregiver: </p>
<p>&nbsp;</p>
<ol>
<li><strong>Take things day by day.</strong> This may sound like pretty basic advice, but there were many times I used this phrase as a lifeline. If I could make it through today and whatever was thrown my way, it was deemed a success. End of story. It&rsquo;s okay to not give a fig about what is going on tomorrow. Trust me, you&rsquo;ll get through it tomorrow.</li>
<li><strong>Build great memories</strong> &ndash; Find something your loved one wants to do and make memories that don&rsquo;t include cancer. It doesn&rsquo;t matter if you&rsquo;re paddle boarding on the shores of your favorite lake, hiking Arches national park in Moab, or curling up with a bowl of ice cream and spending the evening talking about everything under the sun. Take every opportunity you have to create new memories. It is the best time you will ever spend. </li>
<li><strong>Start a digital phone tree</strong> &ndash; Following a cancer diagnosis, there is a large network of people who will want updates on how treatment is going. Ask your loved one if you can begin a group text message to keep everyone informed about the high level information; such as when your loved one has a chemo/infusion treatment scheduled, or perhaps when they have a big scan coming up. If you can text everyone at one time, it will buoy the entire group and take the pressure off of your loved one to try and keep everyone in the loop of what&rsquo;s going on. It&rsquo;s also a wonderful opportunity for you to encourage friends and family to text a kind word or two to your loved one.</li>
<li><strong>Tap into your resources.</strong> When people ask what they can do; delegate, delegate, delegate! Give them specific tasks they can complete to help your loved one. As a caregiver, friends and family are naturally looking to you for guidance. Use this as an opportunity to ask friends and family to drop off dinner, or pick up grocery items on your loved one&rsquo;s behalf. This is incredibly important&hellip;people WANT to help, but you need to tell them what needs doing. </li>
<li><strong>Seek out happiness</strong>. And find more of it. If it&rsquo;s a diet coke in the morning, taking a yoga class with your gal pals, or getting lost in a bookstore; find something that makes you happy daily. Take ten minutes for yourself, even if it is just to breathe, and I promise, it will make you a better caregiver.</li>
</ol>
<p>&nbsp;</p>
<p>It is my sincerest hope that these tips help you as you navigate your caregiver role. There will be times you will wonder how you&rsquo;ll get through this. For those times, please use tip #1 as your own lifeline and know your loved one couldn&rsquo;t be in better hands. If you need anything, please don&rsquo;t hesitate to reach out to us. HI-AYA was established to help you navigate the AYA cancer world, so please, let us help. You can find more information here: <a href="http://www.intermountainhealthcare.org/HI-AYA" target="_blank">www.intermountainhealthcare.org/HI-AYA</a>. </p>
<p>What is HI-AYA?</p>
<p>The <a href="http://healthcare.utah.edu/huntsmancancerinstitute/research/research-studies/hi-aya/" target="_blank">Huntsman-Intermountain Adolescent and Young Adult Cancer Care Program </a>is a collaboration between Huntsman Cancer Institute and Intermountain Healthcare to better meet the needs of adolescent and young adult (AYA) patients.&nbsp;The patient navigator, Sara Salmon, is a trained health educator who is there to talk one-on-one about your unique situation.&nbsp;She can point you to resources and information to get past obstacles in life and healthcare.&nbsp;</p>
<p>If you have questions about fertility, employment, education, health insurance, speaking with your family, and more, please reach out on the &ldquo;How to Get Started&rdquo; page: <a href="http://www.intermountainhealthcare.org/HI-AYA" target="_blank">www.intermountainhealthcare.org/HI-AYA</a></p>Thu, 04 May 2017 00:00:00 -0600{A30BB66A-D6D9-41AB-A38E-EB165F24914E}https://10.40.239.129/blogs/2017/05/dos-and-donts-for-posting-to-social-media/Social Media Do&#39;s and Don&#39;ts <p>The following is a list of suggestions you can review with your teen. These guidelines are also good for adults.&nbsp;</p>
<h4>
Do&rsquo;s
</h4>
<ul style="list-style-type: disc;">
<li>Do be careful what you post: Don&rsquo;t post anything (i.e., pictures, rants, pet peeves) you wouldn&rsquo;t want your grandmother (or future employer) to read. Once it is out there- you can&rsquo;t get it back.</li>
<li>Do be careful if you feel like you are getting consumed: If you can&rsquo;t go more than one day without going online or if you need to spend multiple hours online, you need may need to &ldquo;pull in the reigns&rdquo; a little.&nbsp;</li>
<li>Do remember &ldquo;private&rdquo; does not actually mean private:&nbsp; You can use the privacy settings, but not everyone will.&nbsp; What you mark as private, others may cut, paste, and put on their site.&nbsp; Your site may be private, but is theirs?&nbsp;</li>
<li>Do keep private things private.&nbsp; If you wonder if something is private, then it probably is. &nbsp;</li>
</ul>
<h4 style="margin-bottom: 4.8pt;">Don&rsquo;ts</h4>
<ul>
<li>Don&rsquo;t post suicidal threats or gestures: If you are suicidal, tell an adult you trust.</li>
<li>Don&rsquo;t post anything when you are upset or under the influence: You don&rsquo;t have to say everything you think or feel.</li>
<li>Don&rsquo;t use social media to settle a score: If anyone can be identified in a negative way- don&rsquo;t post it. Don&rsquo;t spread rumors to get even because someone did something you think is unfair.</li>
<li><strong>Don&rsquo;t use social media as a replacement for actual face time:&nbsp; A virtual life is not the same as an actual life.</strong></li>
<li>Don&rsquo;t get caught up in the comparison of social media</li>
<li><strong>Don&rsquo;t friend someone you do not know personally: You don&rsquo;t have to friend everyone.</strong></li>
<li>Don&rsquo;t take the bait: If others do not follow these rules, you don&rsquo;t have to correct them. You don&rsquo;t have to go back-and-forth defending yourself.&nbsp;</li>
<li>Don&rsquo;t post where you are going to be: This is a big safety issue. Don&rsquo;t schedule times and places you are going to meet on Facebook.&nbsp; This opens you up to predators.&nbsp;</li>
<li>Don&rsquo;t search for the negative: Checking to see if anyone is talking negatively about you will only make you feel negative.</li>
</ul>Tue, 02 May 2017 00:00:00 -0600{144EB745-643C-4FBF-A007-4DF05FE2B5E7}https://10.40.239.129/blogs/2017/05/13-reasons-why/A Psychologists Perspective on &quot;13 Reasons Why&quot; and How Parents Can Help<p>The show&rsquo;s protagonist is a fictional teen named Hannah, who commits suicide and leaves behind 13 audio tapes to the persons who have wronged her. While most people who commit suicide do so because they are consumed in his or her pain, the person becomes frantic and &ndash; in all likelihood &ndash; isn&rsquo;t thinking clearly.&nbsp; In contrast, Hannah&rsquo;s behaviors are planned: her suicide is either a bid to teach others a lesson or to gain compassion (i.e., &ldquo;<em>I&rsquo;ll be more loved in death than in life</em>&rdquo;).&nbsp;</p>
<p>Hannah is also memorialized in an unhealthy way. Through voice overs and dramatic flashbacks, she is presented as almost an angelic presence that speaks up heroically for the oppressed. For many teens who struggle with mental health issues, romanticizing Hannah&rsquo;s suicide in this way can be extremely harmful.&nbsp; </p>
<p>This maturely rated show has been highly controversial and while many wonder why, here are a few reasons this show does not meet realistic expectations:&nbsp;</p>
<h3>1. Suicide does not generally change people's behavior&nbsp;</h3>
<p>In the series Hannah&rsquo;s suicide does seem to be initially effective in changing behavior, however this is rarely the case. Many teen viewers may not understand that suicide very rarely results in bullies changing their behavior for the better. The only people that suicide affects in a lasting way tend to be the people that loved the person the most. Suicide is never an effective way to get others to change.</p>
<h3>2. The show models unhealthy ways of coping and reaching out&nbsp;</h3>
<p>Before her fictional death, Hannah &ldquo;reaches out&rdquo; in several ways; however, the show implies that reaching out doesn&rsquo;t work. Hannah talks with a counselor who responds insensitively. Teens in trouble may not understand that the way the counselor responds in the show is not typical, leaving the teen with the message that treatment is bound to fail. After Hannah reaches out, she stops trying to communicate in a healthy way. This type of thinking reinforces depression: &ldquo;If I feel like things are hopeless, then they must be hopeless&rdquo; or &ldquo;If I tried to talk before and it didn&rsquo;t work, then it will never work.&rdquo;</p>
<h3>3. Adults are the enemy</h3>
<p>Many of the adults in the series are depicted as clueless and/or insensitive. They do not listen to Hannah or notice her pain. This sends the unintended message that talking with adults will not be helpful, which we know is not true.</p>
<h3>4. Suicide is not a glamorous or romantic act</h3>
<p>Suicide prevention programs that focus only on &ldquo;suicide awareness&rdquo; or a &ldquo;scared straight&rdquo; approach can have a negative effect.&nbsp; In contrast, effective suicide prevention focuses on screening, good coping, and &ndash; most of all &ndash; ongoing support.&nbsp; In a way, <em>13 Reasons Why</em> normalizes suicide by repetitively emphasizing Hannah&rsquo;s death in such a dramatic fashion. Teens need to understand that most people who struggle with depression, abuse, mental illness, and/or bullying do not commit or attempt suicide. These problems are real and serious, but suicide is not a glamorous or romantic act.&rdquo;</p>
<h2>What Parents Can Do</h2>
<p>The importance of frequently talking and keeping an open, receptive relationship with your teen cannot be overstated.&nbsp; As a society, we need to strike a balance between not dismissing mental health issues (e.g., &ldquo;<em>Oh, it is just a phase&rdquo;; &ldquo;She is only doing it for &lsquo;attention&rsquo;; &ldquo;He&rsquo;ll get over it</em>&rdquo;) and not unintentionally romanticizing mental health issues (e.g., <em>talking endlessly about cutting; repeating stories of dramatic suicide attempts</em>).&nbsp; Here are some quick things parents can do to help their teens.</p>
<h3>Know the symptoms of depression in yourself and others</h3>
<p>Depression is not just a &ldquo;bad hair day&rdquo; or a normal, temporary reaction to discouragement.&nbsp; A Major Depressive Episode, for instance, is defined as someone experiencing five or more of the following symptoms every day (or most days) for two weeks or more:</p>
<ol style="list-style-type: upper-alpha;"></ol>
<ul>
<li>Depressed or Irritable Mood</li>
<li>Sleep Problems (i.e., sleeping too much or too little; sleeping mainly during the day)</li>
<li>Change in Interests (i.e., not being interested in what you used to enjoy) or low motivation</li>
<li>Excessive guilt or unrealistically low self-image</li>
<li>Significantly low energy and/or change in self-care (i.e., not showering anymore)</li>
<li>Significantly worse concentration (i.e., sharp decline in grades or performance)</li>
<li>Changes in appetite (i.e., eating too much or too little)</li>
<li>Agitation or severe anxiety/ panic attacks</li>
<li>Suicidal thoughts, plans or behaviors &ndash; including self-harm (i.e., intentionally cutting or burning yourself)</li>
</ul>
<p>It is important to remember that not everyone who is depressed is suicidal.&nbsp; You can still seek help for your teen even if he or she hasn&rsquo;t demonstrated any specific suicidal or self-harm behaviors.&nbsp; </p>
<h3>Be sensitive/aware of media influence</h3>
<p>Know the shows/ websites your child either watches or frequents.&nbsp; Do they only emphasize depression, mental illness, or self-harm?&nbsp; Or do they also emphasize and model good coping?&nbsp; Do they illustrate positive treatment success stories or do they only focus on how adults &ndash; including professionals &ndash; &ldquo;don&rsquo;t understand&rdquo; for the sake of increasing narrative drama?&nbsp; Be willing to sensitively intervene if the media your child consumes seems harmful.&nbsp; You may not be able to ban all such influences, but you can talk with your teen about the effect that such shows/ websites have on his or her mental health and mood.</p>
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<p>For the same reason a person is struggling with alcoholism and should not hang out around a bar, <em>persons who struggle with depression and self-harm should not electronically hang out where depression and self-harm are major, reoccurring themes.</em></p>
</div>
<h3>Set up &ldquo;Ground Rules&rdquo; for Social Media</h3>
<p>Parents need to educate themselves about Facebook, Twitter, Snapchat and other social media outlets.&nbsp; Setting up ground rules for such outlets is important and is probably not just a &ldquo;one time&rdquo; discussion.&nbsp;</p>
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<p>RELATED: <a href="https://intermountainhealthcare.org/blogs/2017/05/dos-and-donts-for-posting-to-social-media/">Social Media Do's and Don'ts </a></p>
</div>
<h3>Be Open and Receptive</h3>
<p>In my almost 10 years of experience as a clinical psychologist who frequently works with teens and children, here are the top three reasons why teens report they don&rsquo;t open up to their parents:</p>
<ol>
<li>They are afraid their parents will &lsquo;freak out&rsquo;&nbsp;</li>
<li>They assume that if they open up about one thing, they have to open up about everything</li>
<li>They&rsquo;re afraid they will be blown off by parents, who may act like their pain is &ldquo;no big deal&rdquo; &nbsp;&nbsp;</li>
</ol>
<h4>Regarding the &ldquo;my-parents-will-freak-out&rdquo; concern:&nbsp;</h4>
<p>Assure your children that &ndash; while you cannot promise that you will not have any reaction to what they say &ndash; you will be far more open and trusting if they come to you first. Help your teen to understand that if they come to you first, they will keep at least some of your trust. Most parents feel reassured when the teen talks to them first, but you have to back up what you say by not subtly punishing the teen for taking a risk and opening up to you.&nbsp;</p>
<h4>Regarding the &ldquo;Now-I-have-to-be-open-about-everything&rdquo; concern:&nbsp;</h4>
<p>Let your teen know that it&rsquo;s normal to not share everything. Let them know that you&rsquo;ll listen to these other concerns when the time is right; however, there are some topics that you need to know about right away, like:&nbsp;</p>
<ul>
<li>If they or someone else has been (or is) being abused&nbsp;</li>
<li>If they or someone else are thinking of hurting themselves or others.</li>
</ul>
<p>Reassure them that if they talk to you about these concerns, there are other things that they can keep to themselves.</p>
<h4>Regarding the &ldquo;I&rsquo;ll-get-blown-off&rdquo; concern:</h4>
<p>Reassure your teen that you believe that their emotional pain is real. From their point-of-view, it is a big deal. Work out some key words, like &ldquo;Dad, I don&rsquo;t feel safe&rdquo; or &ldquo;Mom, I think I need help.&rdquo;&nbsp; Reassure them that if they use these words, you&rsquo;ll put aside whatever you are doing and listen to them in a private setting.&nbsp; And while you are listening, remember the following adage: <strong>connect before correct</strong>.</p>
<p>Most persons who actually commit suicide are doing so to escape emotional or physical pain. We should not judge them. Watching such media can trigger strong feelings of escape, even in persons who are not contemplating suicide for the reasons depicted in <em>13 Reasons Why</em>. </p>
<h2>Help Resources</h2>
<ul>
<li><a href="http://13reasonswhy.info/#usa">13 Reasons Why help page</a></li>
<li><a href="https://suicidepreventionlifeline.org/#">National Suicide Prevention Online Chat</a></li>
<li>National Suicide Prevention Lifeline: 1-800-273-8255</li>
<li>Utah CrisisLine: 1-801-587-3000</li>
<li><a href="https://healthcare.utah.edu/uni/clinical-services/safe-ut/">Utah "Safe UT" app information</a></li>
</ul>Tue, 02 May 2017 00:00:00 -0600{720DC4FC-C99E-47F1-82F7-FB34BC8FBD89}https://10.40.239.129/blogs/2017/05/5-must-haves-for-a-successful-family-outing/5 Must-Haves for a Successful Family Outing<h2>Use this checklist to enjoy some outdoors with the family:</h2>
<h3>Comfortable shoes</h3>
One thing that will help get the families outdoors and keep them out there are comfortable shoes. Nothing is worse than bringing the wrong footwear for the occasion. Make sure your kids are not taking sandals on a hike or sneakers to the beach.<br />
<br />
When you&rsquo;re wearing the right shoes, it makes hiking, playing, and exploring a whole lot easier and safer. <br />
<h3>Bring lots of water</h3>
When you&rsquo;re outside and active, your body will be losing a LOT of essential hydration. It&rsquo;s important, when outside, to drink lots of water, so plan ahead. Even if the thermometer isn't bursting, bring plenty of water on cool days, too.<br />
<br />
Shoot for several bottles of water per person or bring a refillable water bottle. <br />
<h3>
Check the safety of the location</h3>
When you&rsquo;re bringing your family to a new location to enjoy the outdoors, make sure you check general safety. Become familiar with the terrain and ask questions.<br />
<br />
Such as, is there a body of water? Is the location heavily populated? Are there are wild animal dangers? This doesn&rsquo;t make you a panicky person, it makes you a smart parent and explorer. <br />
<h3>
Don&rsquo;t forget the sunscreen</h3>
When getting the family outdoors, one of the most important things to remember is the sunscreen. A natural zinc based sunscreen can help keep your family safe from the sun without all the harmful chemicals in most sunscreens. Don&rsquo;t forget to also reapply every few hours. Especially if your family is sweating or swimming.<br />
<br />
While sunscreen is important, don&rsquo;t forget hats and sunglasses! Even make sure to bring lip balm &ndash; your lips will thank you later. Proper sun protection is a MUST when getting your family outdoors.&nbsp;
<p>
</p>
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<p>RELATED: <a href="https://intermountainhealthcare.org/blogs/2014/06/safety-tips-for-a-summer-to-remember/">Safety Tips for a Summer to Remember</a></p>
<p>
</p>
</div>
<h3></h3>
<h3>
Have a good park in mind</h3>
One of the best, free things left to do in the world is finding a good park for your family to enjoy. In fact, your kids will be extra motivated to get outside when they know there is a park at stake. Keep the park as a backup plan, in case your other outdoor plans don&rsquo;t work out. Letting your kids run around and have free play is something awesome you can offer them as kids.<br />
<br />
Getting your family outside is one of the best gifts you can grant your family. Sunshine and exploring is something everyone needs. Make sure your family is physically prepared for the outdoors and all there is left is to enjoy your time.
<p>Bonus Tips to Get Started:</p>
<ul>
<li>Try a&nbsp;<a href="https://intermountainhealthcare.org/services/wellness-preventive-medicine/live-well/move-well/healthy-hikes/" target="_blank" style="display: inline !important;">Healthy Hike</a>&nbsp;that is family friendly&nbsp;</li>
<li>Fun ways to&nbsp;<a href="https://intermountainhealthcare.org/services/wellness-preventive-medicine/live-well/move-well/habits/increase-your-activity/" target="_blank" style="display: inline !important;">stay active&nbsp;</a></li>
<li>See how other people are&nbsp;<a href="https://www.youtube.com/watch?v=v39cVOWQ7FQ&amp;list=PLIWYdYatjvoPE7g6vBFlIjFiltBY9EqLg" target="_blank" style="display: inline !important;">living well</a></li>
</ul>Tue, 02 May 2017 00:00:00 -0600